SAN PABLO -- As Contra Costa County officials scramble for options to save Doctors Medical Center in some form, skilled workers are leaving in droves amid the continuing uncertainty.

Hospital CEO Dawn Gideon said 66 workers have left since early May, and about two dozen more have resigned and will be gone in the coming weeks, meaning the staff is down about 11 percent. The drop in staffing hasn't affected hospital services yet, but hospital officials are concerned that could happen if workers continue to flee.

"If that trend (of workers leaving) continues, the hospital is going to shut itself down," said Eric Zell, board chairman of the West Contra Costa Healthcare District, which owns and operates the hospital. "It doesn't mean we cant transition to a new model, but it does mean the continued hope of a full-service hospital is rapidly diminishing."

The exodus comes amid the hospital's prolonged struggles, which worsened when a parcel tax to shore up its balance sheet fell short in May of the two-thirds majority required for passage. The county last month agreed to loan $6 million to keep the hospital afloat until October while other options are explored.

The hospital is running an $18 million annual deficit, mostly resulting from poor reimbursement rates for its predominately Medicare and Medi-Cal patient base.

The healthcare district board on July 15 heard from county health officials about two last-ditch plans to save some level of services at the hospital, either a much smaller facility with 15 beds and an emergency department, or a stand-alone emergency department without inpatient beds.

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But nurses unions and other health care advocates continue to lobby for saving the hospital as is, hoping to shore up its finances with public and private funds.

In a news release Monday, the California Nurses Association called for Chevron Corp. and the county to step in to keep Doctors Medical Center open as a full-service acute care hospital. The union wants the city of Richmond to require Chevron to provide money to the hospital as part of an agreement to approve the refinery's $1 billion modernization project.

Richmond Vice Mayor Jovanka Beckles sponsored a resolution to be heard Tuesday calling on the county to take over the hospital from the healthcare district and provide funding. The nurses union has rallies scheduled for Tuesday and Wednesday to call on Chevron and the county to step up.

Nurses at the hospital acknowledge that many of their colleagues have left amid the mounting uncertainty.

"This uncertainty has gone on for a long period of time, and some workers live elsewhere and have gone on to other, more secure facilities," said Maria Sahagun, a longtime DMC nurse. "But most of us are committed to be here, and if we get new funding, it won't be hard to get new skilled people to fully staff the hospital."

The healthcare district board has a meeting Aug. 5 to get a status report on the hospital's worsening finances and zero in on which option to pursue.

"The sooner we can come to a definitive plan for the hospital's future, the better," said Gideon, adding that in the coming weeks the number of patients in the hospital is expected to dip below 60. The hospital is licensed to carry 189 beds.

"We haven't had to refer anyone to another hospital yet," Gideon said.

County emergency services is expected to begin diverting some ambulances that would normally go to DMC to other hospitals by mid-August, Gideon said.

Longtime nurses at the hospital continue to hold out hope and point to a recent increase in county property tax revenues as further reason the county should save the hospital. Like the hospital's administration, they say a firm plan is key.

"Nurses are called to care for patients," said Seung Choo, a DMC nurse, in an email. "Contra Costa County must act to secure a long-term future for DMC by integrating the hospital into the County Health Services department so that nurses who desire to serve West County can continue to do so. The uncertainty about the hospital's future causes nurses to question if the best place to do that is DMC."

So far, the push to have the county take over and run the hospital in its current form has not gained support among Contra Costa supervisors, who are leery of the costs. The county already runs a hospital in Martinez.

"There is continued pressure on the county to take over the hospital, but it's like trying to squeeze blood out of a turnip," said Supervisor John Gioia, of Richmond, who also sits on the hospital's governing board. "The county can't close the funding gap."